Spending more on health care may not lengthen life the most

Advances in medicine have caused health expenditures to rise and life spans to lengthen in most affluent nations—except the United States.

By Alberto Lucas López and Ryan T. Williams

This story appears in the
January 2019 issue of
National Geographic magazine.

From high-tech surgeries to groundbreaking HIV treatments, medical innovation has dramatically improved health outcomes since the 1980s. In wealthy nations, health care spending has risen, and lives have been lengthened. But the United States follows a slightly different pattern, with skyrocketing health expenditures and a much slower increase in life expectancy. Unequal access to treatment and poor preventive care for many U.S. residents may partly explain the difference, analysts say.

HEALTH EXPENDITURE

LIFE EXPECTANCY

1980

(average at birth)

LIFE EXPECTANCY

2015

(average at birth)

1980

2015

(per person per year, in U.S. dollars)

84

$9,000

Over 35 years,

83

other nations put caps on medical prices and spending to guarantee access to most of their residents, while the U.S. allowed expenditures to

go unchecked.

82

8,000

81

7,000

In 1980,

80

U.S. life expectancy was similar to those of other developed nations, as was spending on health care.

79

6,000

78

78

5,000

77

$4,000

4,000

76

In 2015,

75

despite the most spending per person, U.S. life expectancy ranked the lowest in its peer group, due partially to poor preventive care for less well-off Americans.

3,000

3,000

74

2,000

2,000

73

72

ALL OTHER

OECD NATIONS*

Without universal health coverage

1,000

1,000

71

With universal health

coverage provided by

public and private insurers

$0

$0

Without universal health coverage

With universal health

coverage provided by

public and private insurers

LIFE EXPECTANCY

1980

(average at birth)

72

74

76

78

In 1980,

U.S. life expectancy was similar to those of other developed nations, as was spending on health care.

ALL

OTHER

OECD

NATIONS*

HEALTH

EXPENDITURE

1980

(per person per year, in U.S. dollars)

$0

2,000

$4,000

Over 35 years,

other nations put caps on medical prices and spending to guarantee access to most of their residents, while the U.S. allowed expenditures to

go unchecked.

$0

2,000

4,000

6,000

$8,000

HEALTH

EXPENDITURE

2015

(per person per year, in U.S. dollars)

In 2015,

despite the most spending per person, U.S. life expectancy ranked the lowest in its peer group, due partially to poor preventive care for less well-off Americans.

78

80

82

84

LIFE EXPECTANCY

2015

(average at birth)

*INCLUDES ONLY OECD COUNTRIES FOR WHICH DATA ARE AVAILABLE.
THE OECD IS A GROUP OF 36 OF THE WORLD’S MORE AFFLUENT, DEVELOPED NATIONS.
SOURCES: ESTEBAN ORTIZ-OSPINA, OURWORLDINDATA.ORG,
OXFORD UNIVERSITY; UN POPULATION DIVISION; OECD.STAT